This is one of my rigs... the ghettoest one. Yes, the top card is laying on top of two more. There's a stick of foam near the back of it so it's not directly touching the other cards, just laying on top of them. No, the top PCIe slot in the motherboard doesn't work. Yes, the middle card gets very warm.

Oh, and the fan is for sale, I have two of them. I'll find another way to cool it if someone wants to buy it off me.